Clinical Impact and Perspectives on Comprehensive Genomic Profiling in Advanced Lung Cancer Management

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An expert discusses how comprehensive genomic profiling panels that include relevant targets, resistance markers, and clonal hematopoiesis information have proven most useful, along with technologies that can detect fusion events, point mutations, and copy number variations for serial monitoring over time.

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In his practice, Hatim Husain, MD, utilizes comprehensive genomic profiling panels that include all relevant genomic targets, including resistance markers, to guide treatment decisions effectively. These technologies provide crucial information about clonal hematopoiesis, particularly important in liquid biopsies where genomic alterations in plasma may originate from white blood cells rather than tumor tissue. Advanced platforms offer frameworks to distinguish tumor-derived alterations from those originating in leukocytes, enhancing diagnostic accuracy.

The discussion emphasizes the importance of technologies capable of detecting fusion events, point mutations, and copy number variations. Copy number alterations are increasingly recognized as important factors in understanding driver events vs resistance profiles in lung cancer. Some therapeutic approvals are now based on copy number variations, highlighting the clinical relevance of comprehensive genomic analysis beyond traditional mutation detection.

Technologies enabling serial testing to provide qualitative information about genomic changes over time, offering insights into resistance development and tumor burden evolution. These capabilities allow clinicians to monitor how the genome changes throughout treatment, correlate molecular findings with imaging results like CT scans, and understand resistance mechanisms. This temporal genomic monitoring represents an emerging paradigm in precision oncology, integrating advanced cancer genomics with current treatment approaches.

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